Purpose The search for cause of death is important to improve knowledge and provide answers for the relatives of the deceased. Medical autopsy following unexplained death in hospital is one way to identify cause of death but is difficult to carry out routinely. Post mortem sampling (PMS) of tissues via thin biopsy needle or ‘mini incisions’ in the skin may be a useful alternative. A study was undertaken to assess how this approach is perceived by intensive care doctors and also (...) to evaluate how this practice is considered in ethical terms in France. Methods A study of PMS practices immediately after death in 10 intensive care departments was performed. The medical director of each centre was interviewed by telephone and asked to describe practices in their unit and to outline the questions raised by this practice. Results PMS is routinely performed in 70% of the units which responded, without systematically obtaining formal consent and without precise rules for communicating results. Approaches to PMS differed between centres, but all physicians felt that PMS is useful for the scientific information it gives and also for the information it provides for relatives. All physicians regret the lack of standards to structure PMS practices. Conclusion Information from post mortem examinations is important for society to inform about causes of death, for doctors to improve practices and for decision-makers responsible for organising care. Debate persists regarding the balance between individual rights and community interests. It is suggested that an approach for identifying cause of death could easily be integrated into the relationship between carers and relatives, provided full transparency is maintained. (shrink)

ArgumentThe Germans occupying Paris arrested Emile Borel and three other members of the Académie des Sciences in October 1941 and released them about five weeks later. Drawing on German and French archives and other sources, we argue that these events illustrate the complexity of the motivations and tactics of the occupiers and the occupied. While Borel and his colleagues were genuine members of the Resistance, and those who arrested them were full participants in a brutal occupation, both sides (...) respected a bargain, of no small importance to the Vichy regime, that allowed the university to pursue its work if its members avoided overt acts of opposition. (shrink)

Résumé En 1975, la loi inscrit l’IVG dans la juridiction de la médecine, investie comme instrument du contrôle social dans la régulation des naissances. La demande d’IVG demeurait pensée comme phénomène relevant de la pathologie. Cependant, une normalisation de cette activité s’opère dans le système de soins avec l’évolution de l’encadrement réglementaire et des techniques de prise en charge. Notamment, les sages-femmes sont enrôlées dans le réagencement des formes de l’action publique en la matière. Leur champ de compétence est élargi. (...) Ces nouvelles définitions de l’expertise médicale en santé sexuelle et reproductive donnent lieu à des délibérations sur les conceptions de la pratique abortive. L’association nationale des sages-femmes orthogénistes (ANSFO) se saisit de cette opportunité pour renforcer la légitimité du groupe professionnel, en opérant un travail cognitif de « physiologisation » de l’IVG. (shrink)

Early scientific investigation of the reproductive process was neither a cause nor a direct result of changing social attitudes toward sex. It was instead part of the continuing search, initiated in the 1890s, to discover internal secretions that might be isolated and prove useful in therapy. Laboratory scientists, nonetheless, were among the many groups altering understanding of human sexual physiology in the first quarter of this century. The new data they generated regarding the dependence of human sexuality and fertility on (...) chemical substances elaborated by the ovaries and testes became part of the evidence which hastened that quite tortuous transformation called the sexual revolution.Increasingly, as social reformers demanded more information about human reproduction, scientists were asked to provide it, and scientific concerns were shaped in the process. In the 1920s, especially in the United States, studies of the physiology of reproduction began to receive financial backing from social reformers. This was because for many, contraception had become a fact of life. Expression rather than repression of sexuality was accepted as being necessary to the stability of the fundamental social unit, the family. Theoretical and practical incentives for continued study of the reproductive process could thus be joined in common effort. This convergence of goals occurred just as the gonadal hormones were being isolated. The 1920s, therefore, mark an important juncture in the congruence of interests represented by theoretical science on the one hand and expressed social needs on the other.As a result of this convergence of interests and goals, physiologists gained a new realm of influence, claiming authoritative knowledge over a subject which once had been allocated to the priest and then, by the mid-nineteenth century, transferred to the physician. Since that formative period other research scientists, such as Alfred Kinsey and, more recently, William Masters and Virginia Johnson, have explored that niche and applied the scientific method to study of behavioral and physiological aspects of the human sexual response. They have been beset by many of the same tactical issues that confronted the earliest investigators of reproductive physiology. The definition, specification, and measurement of phenomena relating to sexual and reproductive activity have been as inherently difficult as they have been taboo.79Traditional resistance to scientific study of the reproductive process was overcome in the early twentieth century by the expectation that this particular line of inquiry would lead to understanding and therefore medical control of the complex of disorders—physiological, psychological, and social — associated with the generative glands. Early investigators, particularly in Britain, did not wish to be social reformers. Especially in the 1910s such a stance would have threatened their credibility in a field determined to establish itself as a theoretical science. Once scientific progress was assured, as it was from about 1920, new problems opened for investigation and began to be motivated by social needs as well as by the concerns of a rapidly developing science. Especially in the United States new resources encouraged this work, allowing development of the specialized focus on gonadal hormones represented by the emerging field of reproductive endocrinology. (shrink)

This paper argues that stoicism as a central element of whiteness shapes, controls, and ultimately limits the experience and expression of emotion in public space. I explore how this may play out in particular medical settings like hospitals in Aotearoa New Zealand. I argue that working in conjunction with other values of whiteness identified by Myser —hyper-individualism, a contractual view of relationships, and an emphasis on personal control and autonomy—this makes hospitals emotionally unsafe spaces for Māori and other groups who (...) place high importance in the collective sharing of emotion. Using death and bereavement as an example, I suggest that challenging and addressing stoicism in the structure and performance of whiteness in hospital settings may provide an important point of entry for anti-racism measures and health equity. (shrink)

In spite of these efforts in the 1920s and 1930s to initiate ongoing research on contraception, the subject of birth control remained a problem of concern primarily to the social activist rather than to the research scientist or practicing physician.80 In the 1930s, as has been shown, American scientists turned to the study of other aspects of reproductive physiology, while American physicians, anxious to eliminate the moral and medical dangers of contraception, only reluctantly accepted birth control as falling within their (...) professional domain.As a result, the problem of cheap, effective, and safe contraception was not solved by these earliest attempts. Consideration of the subject was initiated afresh by private philanthropy after World War II, sparked by a new wave of interest in population studies.81 Summarizing such efforts to support research in the reproductive sciences, a recent Ford Foundation study has noted: “To initiate and sustain serious research in the reproductive sciences has required for more than half a century concerted effort by interested individuals and private organizations, mainly from outside the mainstreams of the biomedical research community.”82The early laboratory research on chemical contraception described in this paper was but one important outcome of the concerted effort made by reformers in the 1920s to eliminate a variety of social problems thought to derive from excessive fertility. Scientific arguments and expertise were employed to advocate reform as well as to define the appropriate solution to such social problems. Scientists were recruited as advocates for the movement, but they were also employed as researchers in laboratory investigations sponsored by these same reformers.Sponsors of these early laboratory studies noted the difficulty of obtaining first-class investigators.83 The routine analyses necessary for such research, as well as the traditional scientific aversion to applied problems, provide only a partial explanation for this response. The real difficulty lay in recruiting investigators to a field that had previously been taboo. Once opened up — first as socially relevant, and finally as scientifically sound — there was much interest in this area, and the appeal to researchers of the scientific issues surrounding fertility and reproduction soon surpassed that of the reforming value of birth control.A survey of the kinds of experimental investigations sponsored by birth control advocates indicates the range of physiological problems explored by contraceptive research. The most definitive work was done on the efficacy and safety of spermicides, but the potential of other contraceptive methods was also examined. Investigators attempted to develop spermatoxins that would effectively immunize women against sperm, and they also tried to elucidate the mechanism of hormonal control of reproduction. In fact, speculations about the possible hormonal manipulation of fertility were expressed at the Seventh International Birth Control Conference held in Zurich in 1930.84In the 1920s, clinical studies were undertaken to assess the effectiveness of the various birth control methods. Laboratory investigators complemented this work by screening spermicides for safety and testing for their ability to kill sperm. There were a variety of birth control preparations on the market, but no one really knew whether these were effective or even safe.85 Although the physiology of other major organ systems was well advanced, the scientific study of reproductive physiology and contraceptive technology was clearly in its infancy in this period. Routine analyses simply could not be conducted, because the fundamental research establishing baselines had not yet been done. Scientists used this fact to redirect attention to basic research on reproduction.Laboratory research on contraception indicated important unexplored areas for physiological investigation. Social activists, who had encouraged prominent scientists to become interested in both the social value and the genetic implications of birth control, found these investigators revising the goals of their research. The biologists had formed their own network and had begun to seek out funding, reformulating the justification for sponsorship of further investigations. The eugenic motivations underlying these studies, which had initially made them theoretically attractive to biologists, were gradually eroded. Concern with “human evolution” ceded its place to interest in physiological mechanisms. Crew and others began to note that the use of biological theory to justify essentially political decisions had serious limitations. Biologists had become uncomfortable with those very arguments which had originally captured their interest. Recognition of the potential political abuse wrought by applying scientific principles to society was expressed by Crew just one year after the Zurich meeting. Referring to previous assessments of the role of sex in reproduction, he generalized: “In the past the biologist has justified feudalism, Manchester Liberalism, socialism and every other type of social organization and political programme by reference to selected biological phenomena.”86 By 1932 Crew had also begun to question the biological logic of regulated breeding, and had made it clear to his American sponsor that there was no simple correspondence between the practice of birth control and the genetic improvement of the human race.87Biologists further began to recognize, however, that although the hopeful genetic solution to human problems was probably an illusion, contraception still remained one tangible means to alleviate, human misery. Some laboratory scientists, like Crew, acknowledged the applicability of their own particular skills to this problem. For a few brief years, social needs and scientific goals were mutually supportive and closely intertwined. But as laboratory researchers gained interest in the study of reproduction and established their own priorities in this field, they temporarily withdrew from the arena of debate over birth control as an important mechanism for social reform.With the rise of Hitler, the genetic arguments for birth control rapidly lost their appeal. But by that time the scientific problem of how to achieve effective contraception had entered the professional consciousness. Both physicians and scientists began to be aware of birth control as a subject within their domain of expertise, although outside the principal focus of their research. Scientific discussion of birth control permanently altered from a question of justification to a problem of method: How could one achieve reliable and safe contraception? This had been Sanger's and Dickinson's goal from the beginning. Laboratory scientists had indeed been persuaded to undertake this work; this research had in turn affected biologists' perceptions of the whole field of reproductive physiology, encouraging further study of reproductive mechanisms. The promise of new knowledge provided for continued funding of this research, despite the caution by scientists that the social benefits would not be as immediate or as far-reaching as advocates and they themselves had first argued.The activities of birth control activists and their supporting agencies, and the financial backing of private contributors and foundations, notably the Rockefeller philanthropies, provided an important new stimulus to the development of research on the biology of reproduction in the late 1920s and early 1930s. Biologists were able to claim an enlarged realm of issues for scientific study through their activities as advocates and as investigators for the birth control movement. At the same time, they promised as-yet-undiscovered possibilities for regulating human reproduction once its physiology was understood. The knowledge and control that they promised lay in understanding the whole reproductive cycle — not merely in evaluating the toxic effects of presumptive spermicides.Chemical spermicides never summoned the interest of scientists as the contraceptive pill was to do, yet that research did reinforce the widespread perceptions of scientific research as essential to social reform. Spermicide investigations focused research efforts in reproductive biology by challenging traditional taboos, defining problems for further study, and providing laboratory investigators the opportunity to assert the social and scientific value of their own skills. Crew echoed this attitude as he observed in 1934:Man has turned from the adventurous conquest of his environment to the conquest of himself. To-day is the day of biological invention, eagerly used for the control of the undesirable and the unwanted. Sex and reproduction are no longer hedged around by myth and taboo; they are no longer accepted as mysteries that defy understanding. They are matters inviting examination and explanation; they are regarded as expressions of physico-chemical forces, the nature of which is to be displayed. It is accepted that when knowledge is sufficient, control will be absolute, and, though knowledge is not yet sufficient, readers... must be persuaded to the view that this will not always be so.88The synergism between reproductive biology and social needs has been temporary and sporadic, but recurring, since the 1920s. Scientific research programs have clearly been influenced by issues raised by public debate. Nevertheless, reproductive biologists have continued to assert their own professional goals. For the most part, they have rejected problems without inherent scientific interest and have spurned applied research except as it has had a direct bearing on current research themes. This attitude, apparent among American and British investigators in the 1930s, created the intellectual context for the invention and acceptance of the technically sophisticated oral contraceptive pill. It did not foster the production and improvement of the simple, safe, effective, and cheap vaginal contraceptive desired by early birth control advocates. (shrink)

S'il est vrai qu'aucune passion, aucun souci ne résistent à la sérénité qu'apporte à l'esprit la discipline mathématique, c'est faire une cure de sérénité que lire le nouvel ouvrage d'Émile Borel, qui s'est proposé de raconter, dans ses traits essentiels, l'histoire des relations entre les mathématiciens et la notion d'infini. La première partie du livre relate les circonstances où s'est produite la rencontre des mathématiciens et de l'infini, en Grèce, quelques siècles avant l'ère chrétienne (Zénon, cruel Zénon!). La deuxième (...) partie expose la conquête et l'organisation de l'infini par les mathématiciens modernes, du XVIe au XIXe siècle. La troisième partie, enfin, étudie les plus importantes des difficultés et les divergences de vues qui se sont présentées dans les temps actuels lorsqu'on a cherché à préciser et à approfondir les résultats acquis sur l'infini mathématique. (shrink)

[688/2197] In many economic matters there arises a paradox that may be related to what in logic courses is called the “sophism of the heap of wheat”. Among the sophisms bequeathed to us by the Greeks, none is worthier to have come down through the centuries than this “sophism of the heap of wheat”; indeed this no mere puzzle, but a topical example of a frequent difficulty, as much in practical life as in pure speculation.One grain of wheat does not (...) make a heap; neither do two grains; nor do three grains; \(\ldots \) on the other hand, if a million grains are gathered, we can agree that they constitute a heap. What is the exact limit? Should we say that 2,342 grains, for instance, do not make a heap, whereas 2,343 grains do? This is obviously ridiculous. There appears no logical way out of this dead-end; it is therefore not possible to know what a heap of wheat is.The expression of the sophism can be varied in many ways; a classification of these expressions will not be unhelpful. (shrink)

Book Reviews in this ArticlePaul GochetMaurice BoudotKlaus‐Henrik JacobsenLèon BrunschvicgAndrè Bièler.

With the advent of CRISPR gene-editing technology, designer babies have become a reality. Françoise Baylis insists that scientists alone cannot decide the terms of this new era in human evolution. Members of the public, with diverse interests and perspectives, must have a role in determining our future as a species.

Ever since Kant, the possibility of having objects of knowledge has been one of the most basic anthropological questions (“what can I know?”). For the logician, the linguist, or the semiologist who studies natural language, negation is one of these objects. However, as an operation and as a symbol, it has the paradoxical property of not being able to be objectivized in the discourse that treats it without being used in this construction. Of course, it is an entirely general problem (...) that it is not possible to have a “distant view” of symbolism without using a symbolism of some sort or another. Anthropology is essentially concerned with such objects. The descriptions of ethnologists are thus fertile ground for the epistemologist who believes, like Aristotle, that non-being is not and therefore that, even though in fact we speak only of things (otherwise, what good is speaking?) our discourse cannot be a copy of them. (shrink)

If you retain your belief upon learning that a large number and percentage of your recognized epistemic superiors disagree with you, then what happens to the epistemic status of your belief? I investigate that theoretical question as well has the applied case of philosophical disagreement—especially disagreement regarding purely philosophical error theories, theories that do not have much empirical support and that reject large swaths of our most commonsensical beliefs. I argue that even if all those error theories are false, either (...) (a) the average philosopher’s true commonsensical beliefs are epistemically impoverished, or (b) a good portion of philosophy is bunk and philosophers should give up most of their error theories despite the fact that their supporting arguments are generally as good as or even better than other philosophical arguments. (shrink)

There is a long history of using facts about disagreement to argue that many of our most precious beliefs are false in a way that can make a difference in our lives. In this essay I go over a series of such arguments, arguing that the best arguments target beliefs that meet two conditions: (i) they have been investigated and debated for a very long time by a great many very smart people who are your epistemic superiors on the matter (...) and have worked very hard under optimal circumstances to figure out if the belief is true, and (ii) as far as you know these people have not come to any significant agreement on the belief and as far as you know those who agree with you are not, as a group, in a better position to judge the belief than those who disagree with you. (shrink)

By considering the epistemology and relations among certain philosophical problems, I argue for a disjunctive thesis: either (1) it is highly probable that there are (i) several (ii) mutually independent philosophical reductios of highly commonsensical propositions that are successful—so several aspects of philosophy have succeeded at refuting common sense—or (2) there is enough hidden semantic structure in even simple sentences of natural language to make philosophers highly unreliable at spotting deductive validity in some of the simplest cases—so we are much (...) worse at logic than we think and cannot, in general, know when our own arguments are valid. The untoward consequences of each disjunct are explained. (shrink)

Those of us who take skepticism seriously typically have two relevant beliefs: (a) it’s plausible (even if false) that in order to know that I have hands I have to be able to epistemically neutralize, to some significant degree, some skeptical hypotheses, such as the brain-in-a-vat (BIV) one; and (b) it’s also plausible (even if false) that I can’t so neutralize those hypotheses. There is no reason for us to also think (c) that the BIV hypothesis, for instance, is plausible (...) or probably true. In order to take skepticism seriously it’s sufficient to hold (a) and (b); one need not hold (c). Indeed, philosophers who accept (a) and (b) never endorse (c). Show me a philosopher who suspects that he is a brain in a vat and I’ll show you someone who is deranged! That’s one thing that bothers undergraduates in philosophy. They object: why on earth do some philosophers take the BIV hypothesis to pose any threat at all to our beliefs given that those very same philosophers think that there’s no real chance that the BIV hypothesis is true? Sure, the BIV hypothesis is formally inconsistent with my belief that I have hands, so if the former is true then my belief is false. But so what? Why should that bare inconsistency matter so much? Is this strange attitude amongst philosophers the result of some logic fetish infecting the philosophical community? It is sometimes said that the skeptical hypotheses are not only inconsistent with our beliefs but are explanatory of our experiences, which is supposed to make them more of a threat. But students aren’t fooled: although the skeptical hypotheses may attempt to explain why our experience is as it is, it’s the kind of attempt appropriate for science fiction movies that are all special effects and virtually no plot. No one with any sense of reality will take the evil demon hypothesis to be even tenuously explanatory. (shrink)

Selon Spinoza, les idées appartiennent à la nature au même titre que les corps. Et pourtant ce ne sont pas des corps : seule une physique spéciale, nullement métaphorique, peut rendre compte de l'étrange univers qu'elles composent.

The purpose of this article is to investigate how cultural meanings associated with the left ventricular assist device inform acceptance and experience of this innovative technology when it is used as a destination therapy. We conducted open-ended, semistructured interviews with family caregivers and patients who had undergone LVAD-DT procedures at six U.S. hospitals. A grounded theory approach was used for the analysis. Thirty-nine patients and 42 caregivers participated. Participants described a sense of obligation to undergo the procedure because of its (...) promise for salvation. However, once the device was implanted, patients described being placed into a liminal state of being neither sick nor healthy, with no culturally scripted role. Consideration of end-of-life decisions was complicated by the uncertainties about how patients with LVADs die. Pre-implantation communications among patient, family, and clinicians should take into account the impact of the technology on meaning, identity, and patient experience. (shrink)

A good portion of the work in the ontology of color focuses on color properties, trying to figure out how they are related to more straightforwardly physical properties. Another focus is realism: are ordinary material objects such as pumpkins really colored? A third emphasis is the nature of what is referred to by the terms ‘what it’s like’ or ‘phenomenal character’, as applied to color. In contrast, this essay is exclusively about select color tokens. I will be arguing that whether (...) or not ordinary objects such as pumpkins are colored, regardless of what the true theory of color properties is, and independently of any talk of phenomenal character or what-it’s-likeness, some afterimage experiences are very hard to fit into any plausible ontology, physicalist or not. (shrink)